Could Yoga Benefit Low Back Function and Pain?

Yoga, compared with non-exercise, could provide small to moderate improvements in back-related function at 3-6 months in adults with lower back pain, according to a recent study.

Current guidelines recommend treatment of chronic non-specific back pain with exercise therapy, although the condition is also often self-treated with non-prescription medications.
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In order to assess the effects of yoga on low back pain, researchers conducted a meta-analysis of randomized controlled trials. Studies that were included compared yoga with any other intervention or with no intervention, and those comparing yoga as an adjunct to other therapies versus those therapies alone.

Overall, 12 trials were included in the analysis, involving 1080 individuals. Seven trials compared yoga to no intervention or a non-exercise intervention, 3 trials compared it with exercise, and 2 trials compared it with both exercise and non-exercise interventions. Outcomes were downgraded to “moderate” due to risk of performance and detection bias in the trials.

For yoga compared with non-exercise controls, there was low-certainty evidence that yoga produced small to moderate improvements in back-related function at 3-4 months, moderate-certainty evidence for small to moderate improvements at 6 months, and low-certainty evidence for small improvements at 12 months. The effects on low back pain were not clinically significant.

For yoga compared with exercise controls, there was very-low-certainty evidence for little or no difference in back-related function and 3 months, and no information for 6 months, as well as very-low-certainty evidence for lower back pain at 7 months.

For yoga added to exercise compared to exercise alone, there was very-low-certainty evidence for little or no difference at 10 weeks in function or pain.

Yoga was shown to worsen back pain in 5% of participants.

“There is a need for additional high-quality research to improve confidence in estimates of effect, to evaluate long-term outcomes, and to provide additional information on comparisons between yoga and other exercise for chronic non-specific low back pain,” the researchers concluded.

—Michael Potts

Reference:

Wieland LS, Skoetz N, Pilkington K, et al. Yoga treatment for chronic non-specific low back pain [published online January 12, 2017]. Cochrane Library. DOI: 10.1002/14651858.CD010671.pub2.